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Winnicott's Mindpsyche

and Its Treatment


Joan Lavender

This paper presents Winnicott's concept of Mindpsyche and two


clinical examples of how the concept is applied in two treatment
modalities. First, a discussion among the members and leader of a
dance therapy group is presented, in which participants attempt to
understand why certain moments in the dance experience feel both
frightening and exciting for them. They specify that these moments
have to do with improvising in such a way as to generate a certain
level of arousal which produces a momentary integration of feelings,
thoughts and behavior, and with being seen at such moments. The
author suggests that these experiences of embodiment suggest a solu
tion to the problem of Mindpsyche, which is a state in which the soma
has been drawn into the mind, depriving the individual ofthe natural
process of mutual interrelation between psyche and soma. Moments
of embodiment can be perceived not only by the dancer, but 'by others
who witness the dance. Yet it may be impossible to specify what is
unique to the outward manifestations (the real actions) of these dances
that demonstrates their embodiment. The fIrst ex.ample of
embodiment is from Gendlin's Experiential Focusing. The dance therapist may be in a particularly advantageous position regarding work
with problems of mindpsyche. In the second example, three moments
of treatment are presented, in Which a bulimic patient who is "in her
head" learns how to establish a mutual interrelation betweeIi certain
movement cues and breathing to generate momentary states of em
bodiment.

American Journal of Dance Therapy


Vol. 14. No.1, Spring/Summer 1992

31

1992 American Dance


Therapy Association

3Z

Joan lavender

oward the end of a session, the me~bers of the dance therapy group
reveal a secret. One says, "There is something terrifying about being
seen (dancing) in this way. It's even worse than .my regular (verbal)
therapy session. rve never felt so exposed, but I don't want to stop."
I inquire further, hoping to hear why the dancing is so scary, or why it is
wonderful. The group is puzzled, even though even the most resistant
member agrees that this mixture of terror and elation is what she feels too.
Someone says, "It's something about being seen. You are watching me
make dances and you delight in my attempts." Another member adds, "No,
you don't love us for this, you laugh at us." The group agrees that it has
something to do with being watched, and that it works best when they feel
my concern and not criticism. They have established one aspect of the
secret: it has something to do with being seen. '
They speculate further. It doesn't happen all the time, or in every dance.
It only happens when the dancing comes from a certain level. What level?
It comes when r notice my breathing and stay in touch with how my
muscles feel. Finally, a member says quietly, "I know why this scares me.
I think it's like being born. It feels like my mind is showing itself through
my dances, and that is what you are seeing .
The group develops this theme, corroborating unknowingly with Winnicott's concept of Mindpsyche.
One might ask what happens if the strain that is put on mental
functioning organized in defense against a tantalizing early environment is greater and greater? One would expect confusional states and
(in the extreme) mental defect of the kind that is not dependent on
brain-tissue deficiency. As a more common result of the lesser
degrees of tantalizing infant care in the earliest stages we fmd mental
functioning becoming a thing in itself ... This is a most uncomfortable
state of affairs, especially because the soma of the individual gets
seduced away into this mind (and away from its natural relation with
the soma. <Winnicott, 1958, p. 246).

A member of the group stated, '1 never felt like my body belonged to me
anyway . You can beat it up and it doesn't matter to me. The problem is
that it's palpable. Now, my mind is something else. That's where r live. n
The group members nod in unanimous agreement. People with severe
eating disorders, self-mutilators and prone to accidents of all kinds, they
frustrate staff with the tenaciousness of their se!fCbody-) destructiveness.
They play with death. In this session, they are uneasy letting me know
where they "live" because I will demand embodiment from them, and
leave them no escape.
r suggest that what these people are experiencing during their scariest
moments in dance are momentary episodes of integration of psyche and
soma, which Winnicott defined in the folloWing way:

Winnicott's Mindpsyche

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the imaginative elaboration of somatic parts, feelings and


functions of physical aliveness ... The psyche and soma
develop. in a process of
mutual interrelation, and with an inside and an outside is felt by
the individual to form the core for the imaginative self ......... the
psyche
is not, however, felt by the individual to be localized in the
brain, or indeed to be localized anywhere. <Winnicott, 1958, p.
244)

These moments of "embodiment" are indeed felt by each dancer creating


a certain kind of dance; they are also witnessed by the rest of the group
who are observing, not casually but intensely. The members of the group
are often moved precisely by the same moments in .the dance that excite
the dancer: and it is these moments about which the dancer has much to
say. The talking is about something new that has occurred to the dancer
while dancing, or it is about something already known that now
resonates on a deeper level.
.
What are the observable features of a dance that is "embodied"? How .
can one determine that the dancer is indeed "behind" her dance?
There is no way that I know to describe the particular qualities of such a
dance. AB Winnicott said-it is not localizeable. However, it is possible to
speak of a kind of balance or integration of various movement qualities
that is so subtle, yet present. One dance therapist refers to the "implicate
order" revealed in such dances. CR. Wiener, 1983, personal communication.) This phenomenon has also been described as a kind of "tracking of
experience" producing a result which is simultaneously unique and universal. The particular movement qualities of the dancer are idiosyncratic,
but the moments of balance and search for balance itself, Le. the dance,
has the aesthetic appeal of an artistic experience.
As far as the setting and the patient population, I am writing here from
treatment experiences involving severely-personality-disordered individuals in a group therapy using dance movement as the modality of treatment. Mindpsyche is the problem. I start with dance because it precedes
the verbal realm, thus simplifying the task of establishing integration
between various domains of development. Movement integration (between
various systems of outer behavior and psychic life) ~1l precede integration
of movement with verbal life. In other words, meaningful movement
precedes meaningful speech.
The first clinical example is of an internal psychic movement process
which can also serve to generate actual movement. I offer it to prepare the
reader for the second clinical example, which has both an internal
movement process and an externalized dance experience. Based on Eugene Gendlin's Experiential Focusing, this approach asks the patient to
carefully choose words that fit the felt-meaning of his bodily experience.
Although there are no gross body movements involved in this approach,

34

Joan Lavender

there are significant shifts of breathing and posture that signify shifts in the
inner process of the patient .. ~
G. is a 30 year old man, severely-disturbed, depressed and painedlooking. Once able to attend a fme graduate school in English literature, he
has spent the last few years unable to use his talents and requiring repeated
hospitalization. Whatever the details of Go's past, one look at him and it is
clear that he has undergone a loss of his sense of physicality and is in the
grip of a mind gone desperate. His voice is flat,his chest concaved and
inert-looking. He describes himself as a dead body, yet on the brink of
desperation. G. says flatly that he is in a state of anguish, but is unable to
relate this to inner or external events. This paradoxical presentation is
quite unusual.
The only liveliness in G.'s presentation is terse pulling action in his
fingers, which he applies to the tuft of hair he is preparing to yank out of
his scalp. G. does not appear to notice that he is tearing his hair out.
Perhaps he is in a heightened state of mindpsyche where feelings are
~ought" but not felt .. '
T: Can you go inside for a while, finding the place right underneath
your breathing, where you feel your feelings?
G: I don't feel anything ....
T: Ok. Is there a place where you don't feel the anything?
G: ... I think there is something .... it's in my heart ... yes, there is
something in, near my heart ... like rve been stabbed. An image goes
with this ... of a huge knife. (minutes pass, G. is breathing more easily
and visibly now.) This heart needs comfort ... (hesitating) I need
comfort ... the worst part of this is the feeling of not being able to
communicate ...
T: How is it now?
G: It's lighter in there now ... some energy ... but the stabbing is more
intense at the same time. (He looks as ifhe will cry, does but he does
not.) It feels like I should go on .... but that is just what I always do. I
always go on. Now I can feel this. My head is talking now, my mind is
telling me to go on. I am always pushing my body against this mind. I
didn't notice this before. My body wants to rest, then it will be able to
go on ... this is the piece I have missed ... this "pushing against"
feeling. rm tired now, but I feel eased up too.

G. has been working this way for about ten minutes. The group has been
watching him, and they seem to reflect the change in his manner throug4
their breathing and steady gaze. G. returns the following day cleanshaven,
without pulling his hair, and says that he has less pressure in his head. He
speaks about personal losses suffered during t'he last two years and
wonders if he had not paid sufficient attention to his feelings about them.
Maybe he never took the time to mourn.
G.'s momentary experience of psychosomatic integration left its effect.
It remained in an understated way over the next week, and was remem-

The dance becomes the search for and evidence of a certain level of
reciprocity between psyche and soma. By temporarily tuning out the
complex channel of spoken language, which::carries within the capacity for
double entendre and innuendo, the patient has" a Bimpler but still complex
task. An automatic checking back process between external movement and
sensation, cognition and affect forms itself into D;lovement patterns. The
patterns relate to other patterns which have a felt-meaning for the dancer. A
dancer without mindpsyche will not have',an internal bodily reference point
with which to improvise. She will either not be able to move at all, will get
stuck in stereotype and movement ruminations, or will complete a dance
without any sense of ownership or satisfaction. Someone watching such a
dance will have a similar sense of dissatisfaction or boredom. Kinaesthetic
empathy will be not evoked, although SYmpathy for the detached dancer
might be.

Three Critical Incidents from the Case of"J.:


A Search for Mindpsyche
J. is diagnosed as having a borderline level of personality organization and
a severe anorexia and bulimia. Once a child prodigy, she has not been able
to work or to socialize for many years, having destroyed professional and
personal relationships under the tyranny of her severe eating disorder. Her
binges were daily, and included one incident in which she swallowed a
metal spoon. J. is a small woman, thin but not emaciated, with a pallor and
swollen glands from vomiting. Her face has a forced frozen smile that
evokes a "mugging for the audience." J. is ingratiated and grandiose,
mixing stories of her unusual childhood with confabulation. She complains
of being misunderstood, and of not knowing what she feels. She is a liar. J.
describes her problem as "trying to get my sense of who I am to come
down from my mind into my body,"

Incident 1
J. offers to do the fIrst solo dance in a group, by improvising to the theme
of "finding herself." Exhibiting none of the natural shyness often seen in
solo work, she leaves the group behind and strides out in the dance space.
She stands in the center of the floor. Her breath is held, her chest is puffed
out and looks immobile. J. stretches her arms out to their fullest, and acts
out the gesture of searching for an embrace. She fInds none, and

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wraps her arms around herself in a hug. This dance is mimed. The group
watches respectfully, but they are not moved~:They are learning to identify
authenticity through their own responses: and J. is ~n need of some. One
member asks her why she is looking "out there" to find herself "in here." J. is
puzzled, caught off guard, and appears vulnerable. She had used the only way
she knows to find approval-looking "out there."
I ask J. to try again, in a brief improvisation. This time she will sit among us.
There is no need to move away so soon or so far; her geographic separation
from us is not accompanied by psychic individuation. I suggest that J. spend a
full minute simply noticing her breathing and its movement. J. puffs herself up
and forces a hollowing exhalation. She is afraid that her own respiration is not
adequate, and that we, the audience, won't see anything happening. Even so, a
feeling begins to form arpund her as she sits in stillness. She moves without the
abrupt announcement offfnow I am going to start." Her transition into movement
flows from breath and she follows this subtle change in her torso. She seems to
fi,ll with substance. J. follows the line of gravity, and finds her head rolling
down to the floor. Her grin has dissolved, revealing the face of a frightened
child.

J: I don't know what that was. I felt something in my arms and


stomach. I wanted to roll more, with my head going all the way, but
there was such pressure in my head. rve been lowering my head of a
toilet bowl for so long now, I forgot to notice that moment ... you have
no idea what it is like, to spend your life with your head over the
toilet.
Group Member: I never saw you be so simple before. I feel like I
really saw you.
J: (Confused but interested) What do you mean? What was different?
(pausing, she checks her inner state.) I am so hungry now. I don't think
it's food that I want.

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In the following weeks, J. begins to identify a variety of mixed feeling states


that are lodged psychically and somatically in her stomach. These feelings
produce physical pain and a sense of starvation. Then, they become
psychological hunger. J. lies curled up on the floor, crying that her anger is
bigger than she is, and that she is too small and young to contain it. She curls
herself near the other group members, and peeps out to watch them dance. She
states that she is hungry, and her eyes are hungry to take in our bodies. She
remains in contact with the reality of the sessions, and also takes these reactions
to her individual psychotherapist.

Incident 2
J. has made a trial attempt to stop binging.. She is growing long hair, has
started to experiment with makeup, and has given uptomboyish overalls.
In dance sessions, she is often doubled over with emotion that registers as
physical pain. She is finding that her eating disorder hurts, and she can feel
it. J. insists on dancing in sessions despite the pain, and we discuss how
much her body can sustain. During this phase she must dance a bit and
then watch. She must take bite-size amounts, although her impulse is to
gulp down the dance improvisation. In one session she pulls herself free
from the group, and stands at the sidelines. She recalls having been a
wallflower. She asks us to let her lead a group improvisation. She wants
us to lift her. J. is pleased and embarrassed by this urg~.

Incident 3
J. has become less verbose, more expressive and her dances are eloquent.
Today is the last session offour months. Her dance is a mixture of sadness
and pride. She is able to move from floor to leaping in the air without
losing a sense of physical transition. She is subtle in gesture, and her
tension is modulated. The significant gesture occurs when J. begins to grab
for her sinking sweatpants. Is this a little girl losing her pants, or a woman
disrobing? J. is no longer cute. She is intrigued that her dance both
contains and communicates her sense of female sexuality. She finishes the
dance with a duet, dancing with another woman whom she has previously
avoided. The dance partner is a remote woman, known for her sexiness.
She starts to cry as J. displays her conflict of woman vs. child.
J.'s body continued to feel more responsive, and her movement became
truer to itself. One could say that she had developed a sense of integrity.
This change affected every area of her life. She recognized hunger in her
stomach, and began to modulate her need for real food. She differentiated
real hunger from her legitimate need for human contact. She could sense
when her movement was false, and felt more reliable. J.'s progress in the
treatment of her problem with mindpsyche included the following
achievements:
1. The establishment of an improved relationship between J. and her
breathing process. I asked J. to keep her awareness partly on her breathing
while she danced. Doing so produced associations. These related to her
fear of breathing, and her belief that she could stop her own breath.
Slowly, she had developed a psychological reliance on the continuity of
that physical process. As she solved movement problems in order to
improvise, she began to feel a sense of continuity throughout her life.

Winnicott's Mindpsyche

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39

2. Awareness of muscular sensations as distinct from inner organ perception.


J. had identified her body's need for a c~rtain level of stimulation and rest. A comingling of breath and muscular awareness produced J.'s ability to sense
pleasure in her dances ..
3. With the establishment of the above, J. began to feel safer. Memories and
associations occurred during her dances. She could contain these and
communicate them simultaneously.
'
4. The majority of interpretations made during J.'s dances were selfinterpretations. These understandings remained with her, and seemed to have
general application.
J. had the beginning of mindpsyche. Her particular movement attributes
included the use of very large expanses of space around her body (she moved as
if she were still large), many reaching gestures, and lots of leaping. These
choices lend themselves to interpretation. But my point here is merely to say
that they began to work in an adaptive integration for her. Careful attention paid
to breath, muscle and inner state enabled J. to treat her mindpsyche, and a
simpler verbal style ensued.
I suggest that J. learned to soothe herself, and to simultaneously contain and
express herself through movement precisely because she worked directly with
her body. In a sense, a moving body can be thought of as our original holding
environment, in which the satisfactory and mutual interrelation of psyche and
soma, under optimal circumstances, produces a sense of aliveness. When J.
could develop this function, even in moments, the group could confirm her
achievement through their sensitive observations. It is in this sense that I came
to appreciate the group's secret, when they shared the excitement and terror of
being born anew.

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References
Gendlin. E. (1971) A Theory of Personality Change. In A. Mahrer and L. Pearson (Eds.) Creative
Developments in Psychotherapy. Cleveland, London: Case Western Reserve.
Gendlin. E. (1973) Experiential Phenomenology. In Phenomenology and the Social Sciences,
M. Natanson. (Ed,) Evanston: Northwestern University Press.
Lavender. J. (1983) "Stepping Out and Acting Up," unpublished manuscript.
Weiner. H. (1983) personal communication .. Winnicott. D. (1958) Mind and its Relation to the
Psyche.Soma, in Collected Papers;
Through Pediatrics to Psychoanalysis. London: Tavistock: New York: Basic Books.